About our financial assistance policy (FAP)

Financial assistance is available only for services provided directly by a Northwell Health hospital facility or by a physician employed by Northwell Health. For a list of Northwell Health hospital services that are performed by employed physicians who are covered under this policy, please click here.

The appendices below are listings of independent service providers or practitioners, that are not employees at a Northwell Health facility, but deliver emergency or medically necessary care, and whose services may not be covered under this FAP.

Plain language summary languages available:

Eligibility

In general, eligible patients may receive financial assistance, using a sliding scale, when their family income is at or below 500 percent of the federal government’s Federal Poverty Guidelines (FPG). Eligibility for financial assistance means that eligible patients will have the cost of their care reduced in full or in part, and they will not be billed more than “Amounts Generally Billed” (AGB) to insured persons (AGB, as defined in IRC Section 501(r) by the Internal Revenue Service). The following financial assistance is available to eligible patients:

Family income at 0 to 100 percent of FPG

Full financial assistance

$0 or the nominal payment level as defined by New York State Department of Health is billable to the patient.

Family income at 101 to 500 percent of FPG

Partial financial assistance

AGB is maximum amount billable to the patient.

Other relevant criteria in addition to FPG may be considered in determining eligibility, which may result in exceptions to the preceding. Northwell’s financial assistance departments will review submitted applications which are complete, and determine financial assistance eligibility in accordance with the financial assistance policy. Applicants who provide incomplete FAP applications will be notified and given an opportunity to provide the missing documentation/information in order for a determination to be made with respect to eligibility for financial assistance.

How to apply

FAP and related application form may be obtained/completed/submitted as follows:

Submit a completed application and required documentation to the respective financial assistance department based upon the hospital facility that provided the services.

Applications for financial assistance can be obtained as follows:

At each Northwell hospital facility’s main registration desk or emergency room desk

Request documents to be mailed to you by calling Northwell Health’s Financial Assistance Unit at (800) 995-5727

Request documents by mail/or in person at the respective hospital facility that provided services

For more information

Northwell also translates its financial assistance policy, financial assistance application and this plain language summary in to other languages. Translated versions are available on Northwell’s website or upon request in person at the addresses below. For assistance or questions, please visit a Northwell hospital facility’s main registration desk or emergency room desk or the locations listed below, Monday through Friday from 9am to 5pm. A financial counselor can also be reached by phone at (800) 995-5727.

Our representatives are available to schedule your appointment on weekdays from 8am to 8pm and weekends from 9am to 5pm. You may also leave a voicemail message after regular business hours, and we will return your call.